MEDICARE: SENIOR HEALTH PARTNER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	4704267744	MI

General Provider Information

NPI Number	:	1902349160
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SENIOR HEALTH PARTNER

Provider Business Mailing Address
First Line	:	PO BOX 7060
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48121-7060
Country	:	US
Telephone Number	:	313-355-9800
Fax Number	:	313-557-0144

Provider Business Practice Location Address
First Line	:	10140 VERNOR HWY
Second Line	:
City	:	DEARBORN
State	:	MI
Zip	:	48120-1515
Country	:	US
Telephone Number	:	313-413-8684
Fax Number	:	888-242-0942

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MS. VERA JABER
Credential	:	NP-C
Telephone Number	:	313-384-3069

Provider Enumeration Date	:	11/21/2016
Last Update Date	:	07/21/2022

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